Cytological Evaluation of Serous Body Fluids: a Two Year Experience in Tertiary Care Centre from Central India

Background: Cytological examination of serous body fluids is extremely important since it throws light on the cause, presence of metastatic cells, typing of unknown cases, staging and prognosis of cancer. Aims and Objectives: 1) To study and evaluate current trends in cytological evaluation of serous effusions for various pathological conditions in a tertiary care centre. 2) To analyse their frequency in relation to diagnosis. Material and Methods: Our Study was cross-sectional study performed in Department of Pathology, Sri Aurobindo Medical College and Post Graduate Institute from 1st January 2013 to 31st December 2014. Serous effusions included in the study were pleural, pericardial and peritoneal in origin. All other fluids were excluded from the study. The clinical history and relevant parameters were noted and correlated clinically. Conventional smears and cytospin method were performed on all fluids. Both air dried and wet fixed smears in methyl alcohol were used and stained with Papanicolaou(PAP) and May-Grunwald-Giemsa(MGG) stain. Results: Out of 902 cases, 400(44.3%) were pleural fluid, 485(53.7%) were peritoneal fluid and 17 (1.9%) were pericardial fluids. 820 (90.9%) were of benign effusion and 82(9.1%) were of malignant effusion. Total transudate cases in our study were 622 (68.9%) and exudates were 280 (31.04%). Male to female ratio was 1.5:1 with youngest patient 20 years old and eldest was 85years old. Conclusion: Benign effusions are common in younger age group and malignant in older age group. Combined approach to morphology with May-Grunwald-Giemsa (MGG) and Papanicolaou (PAP) helped in better interpretation than either methods used individually. Preliminary fluid analysis for cytology in resource limited settings, still remains the most convenient and cost effective method in arriving at the diagnosis, thereby reducing the need for invasive investigations and their related complications. Presence and absence of malignant cells at times can be the only clue to the presence of malignancy thereby affecting the prognosis and treatment outcome of the patient.